need advice

[mamashark]

We got mental health benefits in the fall, called to get on the waiting list for a behavioral eval for our then 4 year old son. Had trouble finding a place that took our insurance so ended up at a private psychologist that was recommended by our family dr.

Filled out a boatload of paperwork, got on the schedule for January 2018, right as he was turning 5. In January we had 2 visits, an initial visit where she got to see some of his "shutdown" behavior, and she sent home another parent and teacher standardized evaluation for us and one of his Sunday school teachers to fill out. The second visit we turned in those evals and at a glance she told us "he obviously has a lot of things going on" and began going over some of the initial paperwork with us. 

When I asked about autism, she said there were signs of it on paper, but she preferred to refer out for that diagnosis. I explained the insurance issue and she said that we would see what she could do because they do have a multi-disciplinary team at her office, but that for now, his official diagnosis would be "anxiety". She mentioned OCD at that appointment too. She wanted 3 more appointments before we went any further, one with him and mom, one with him and dad, and one with him alone. Then we would meet again. In the meantime we were to start OT with him.

Then she got the flu, we had several weeks of bad weather, we had a traumatic death in the family, and finally, 3 months later, we were able to get back on her schedule. Got those 3 requested visits in, then a parent meeting.

That parent meeting was very frustrating for us - she wanted to know how we felt about our experiences with him during those individual sessions, asked for general updates on how things were going, reiterated again that we needed to go on dates to have a break from him, and told us her observations were that he fidgeted and wasn't 100% focused on the games we played, which caused him to make mistakes or miss some of the directions.  Literally nothing else. When I asked for copies of her evaluations because our insurance is changing in July and she'll be out of network, she told me rather condescendingly that she never did any "official" evaluations, and a conversation with a new psychologist would be more helpful to us than any papers.

I talked to the OT about it and she told us to request a written report of her findings. So I called and left a message explaining nicely that we must have miscommunicated our desired request for a behavioral evaluation, apologized for any confusion, and stated that we would like a written report of her findings and to cancel our next 2 meetings. 

I just got a voicemail from her explaining that she had missed her note to herself at the bottom of the back of his file to finish going over the behavioral categories, and that we should use one of the next scheduled meetings to go over that and talk about "the rest of it and what it looks like in regards to an autism diagnosis and how that impacts other treatments that we seek out for him". She said she can do a written report for us too, and to call back and let her know how we would like to proceed.

I feel like we've waste so much money on her already and we are seeing HUGE improvements in behavior with diet change and OT (where he's in a social group) and that she was unprofessional and unprepared and I don't really want to spend more money on another visit with her... and all the complication that goes along with finding a babysitter for all the kids (the last time we had to do that, my in-laws kept them and they broke his special diet and we had a week's fallout from it in his behavior...)

An autism diagnosis at this point isn't going to be very hugely helpful because we've been able to solve the majority of the behaviors ourselves. 

For example - he's now eating well,

his "fits" last mere minutes and he is able to talk about them and take responsibility for cleaning up any messes, and these fits are not even every day (as compared to multiple 20+ minute fits daily before). I'm able to pick more battles and start over with teaching him appropriate behavior even if he's not happy by my request. He rarely truly melts down anymore (less than once a week if that)

He rarely shuts down unless we are leaving somewhere and he doesn't want to go.

He's sleeping in his bed more than 1/2 the time now (instead of never)

he wears jeans without a problem.

He's fully day-trained now,

has been going to his classes at church without a parent for several weeks.

He's not displaying the autistic-like repetitive behaviors anymore,

his sensory sensitivities are drastically reduced (now he only doesn't "like" getting dirty or sprayed with a hose... but is willing to take baths, brush teeth, wear all kinds of clothes, walk barefoot outside, etc)

He's made several friends his own age, and while he's overwhelmed by large groups still, he is able to manage without a behavioral issue so long as he's well rested and not hungry.

So what do I do about the psych??

[Lecka]

I think I would lean towards no more money, and writing a letter requesting the write-up and send a copy to  the professional organization she belongs to.